Charged particle cancer therapy x-ray method and apparatus

ABSTRACT

The invention comprises an X-ray method and apparatus used in conjunction with charged particle or proton beam radiation therapy of cancerous tumors. The system uses an X-ray beam that lies in substantially the same path as a proton beam path of a particle beam cancer therapy system. The system creates an electron beam that strikes an X-ray generation source where the X-ray generation source is located proximate to the proton beam path. By generating the X-rays near the proton beam path, an X-ray path that is essentially the proton beam path is created. Using the generated X-rays, the system collects X-ray images of a localized body tissue region about a cancerous tumor. The generated image is usable for: fine tuning body alignment relative to the proton beam path, to control the proton beam path to accurately and precisely target the tumor, and/or in system verification and validation.

CROSS REFERENCES TO RELATED APPLICATIONS

This application claims benefit of:

U.S. provisional patent application No. 61/055,395 filed May 22, 2008;

U.S. provisional patent application No. 61/137,574 filed Aug. 1, 2008;

U.S. provisional patent application No. 61/192,245 filed Sep. 17, 2008;

U.S. provisional patent application No. 61/055,409 filed May 22, 2008;

U.S. provisional patent application No. 61/203,308 filed Dec. 22, 2008;

U.S. provisional patent application No. 61/188,407 filed Aug. 11, 2008;

U.S. provisional patent application No. 61/209,529 filed Mar. 9, 2009;

U.S. provisional patent application No. 61/188,406 filed Aug. 11, 2008;

U.S. provisional patent application No. 61/189,815 filed Aug. 25, 2008;

U.S. provisional patent application No. 61/208,182 filed Feb. 23, 2009;

U.S. provisional patent application No. 61/201,731 filed Dec. 15, 2008;

U.S. provisional patent application No. 61/208,971 filed Mar. 3, 2009;

U.S. provisional patent application No. 61/205,362 filed Jan. 12, 2009;

U.S. provisional patent application No. 61/134,717 filed Jul. 14, 2008;

U.S. provisional patent application No. 61/134,707 filed Jul. 14, 2008;

U.S. provisional patent application No. 61/201,732 filed Dec. 15, 2008;

U.S. provisional patent application No. 61/198,509 filed Nov. 7, 2008;

U.S. provisional patent application No. 61/134,718 filed Jul. 14, 2008;

U.S. provisional patent application No. 61/190,613 filed Sep. 2, 2008;

U.S. provisional patent application No. 61/191,043 filed Sep. 8, 2008;

U.S. provisional patent application No. 61/192,237 filed Sep. 17, 2008;

U.S. provisional patent application No. 61/201,728 filed Dec. 15, 2008;

U.S. provisional patent application No. 61/190,546 filed Sep. 2, 2008;

U.S. provisional patent application No. 61/189,017 filed Aug. 15, 2008;

U.S. provisional patent application No. 61/198,248 filed Nov. 5, 2008;

U.S. provisional patent application No. 61/198,508 filed Nov. 7, 2008;

U.S. provisional patent application No. 61/197,971 filed Nov. 3, 2008;

U.S. provisional patent application No. 61/199,405 filed Nov. 17, 2008;

U.S. provisional patent application No. 61/199,403 filed Nov. 17, 2008;and

U.S. provisional patent application No. 61/199,404 filed Nov. 17, 2008,

all of which are incorporated herein in their entirety by this referencethereto.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates generally to treatment of solid cancers. Moreparticularly, the invention relates to a charged particle cancer therapyX-ray method and apparatus used in conjunction with radiation treatmentof cancerous tumors.

2. Discussion of the Prior Art

Cancer

A tumor is an abnormal mass of tissue. Tumors are either benign ormalignant. A benign tumor grows locally, but does not spread to otherparts of the body. Benign tumors cause problems because of their spread,as they press and displace normal tissues. Benign tumors are dangerousin confined places such as the skull. A malignant tumor is capable ofinvading other regions of the body. Metastasis is cancer spreading byinvading normal tissue and spreading to distant tissues.

Cancer Treatment

Several forms of radiation therapy exist for cancer treatment including:brachytherapy, traditional electromagnetic X-ray therapy, and protontherapy. Each are further described, infra.

Brachytherapy is radiation therapy using radioactive sources implantedinside the body. In this treatment, an oncologist implants radioactivematerial directly into the tumor or very close to it. Radioactivesources are also placed within body cavities, such as the uterinecervix.

The second form of traditional cancer treatment using electromagneticradiation includes treatment using X-rays and gamma rays. An X-ray ishigh-energy, ionizing, electromagnetic radiation that is used at lowdoses to diagnose disease or at high doses to treat cancer. An X-ray orRöntgen ray is a form of electromagnetic radiation with a wavelength inthe range of 10 to 0.01 nanometers (nm), corresponding to frequencies inthe range of 30 PHz to 30 EHz. X-rays are longer than gamma rays andshorter than ultraviolet rays. X-rays are primarily used for diagnosticradiography. X-rays are a form of ionizing radiation and as such can bedangerous. Gamma rays are also a form of electromagnetic radiation andare at frequencies produced by sub-atomic particle interactions, such aselectron-positron annihilation or radioactive decay. In theelectromagnetic spectrum, gamma rays are generally characterized aselectromagnetic radiation having the highest frequency, as havinghighest energy, and having the shortest wavelength, such as below about10 picometers. Gamma rays consist of high energy photons with energiesabove about 100 keV. X-rays are commonly used to treat cancerous tumors.However, X-rays are not optimal for treatment of cancerous tissue asX-rays deposit their highest does of radiation near the surface of thetargeted tissue and delivery exponentially less radiation as theypenetrate into the tissue. This results in large amounts of radiationbeing delivered outside of the tumor. Gamma rays have similarlimitations.

The third form of cancer treatment uses protons. Proton therapy systemstypically include: a beam generator, an accelerator, and a beamtransport system to move the resulting accelerated protons to aplurality of treatment rooms where the protons are delivered to a tumorin a patient's body.

Proton therapy works by aiming energetic ionizing particles, such asprotons accelerated with a particle accelerator, onto a target tumor.These particles damage the DNA of cells, ultimately causing their death.Cancerous cells, because of their high rate of division and theirreduced ability to repair damaged DNA, are particularly vulnerable toattack on their DNA.

Due to their relatively enormous size, protons scatter less easily inthe tissue and there is very little lateral dispersion. Hence, theproton beam stays focused on the tumor shape without much lateral damageto surrounding tissue. All protons of a given energy have a certainrange, defined by the Bragg peak, and the dosage delivery to tissueratio is maximum over just the last few millimeters of the particle'srange. The penetration depth depends on the energy of the particles,which is directly related to the speed to which the particles wereaccelerated by the proton accelerator. The speed of the proton isadjustable to the maximum rating of the accelerator. It is thereforepossible to focus the cell damage due to the proton beam at the verydepth in the tissues where the tumor is situated. Tissues situatedbefore the Bragg peak receive some reduced dose and tissues situatedafter the peak receive none.

Synchrotrons

Patents related to the current invention are summarized here.

Proton Beam Therapy System

F. Cole, et. al. of Loma Linda University Medical Center “Multi-StationProton Beam Therapy System”, U.S. Pat. No. 4,870,287 (Sep. 26, 1989)describe a proton beam therapy system for selectively generating andtransporting proton beams from a single proton source and accelerator toa selected treatment room of a plurality of patient treatment rooms.

Transport/Scanning Control

K. Matsuda, et. al. “Particle Beam Irradiation Apparatus, TreatmentPlanning Unit, and Particle Beam Irradiation Method”, U.S. Pat. No.7,227,161 (Jun. 5, 2007); K. Matsuda, et. al. “Particle Beam IrradiationTreatment Planning Unit, and Particle Beam Irradiation Method”, U.S.Pat. No. 7,122,811 (Oct. 17, 2006); and K. Matsuda, et. al. “ParticleBeam Irradiation Apparatus, Treatment Planning Unit, and Particle BeamIrradiation Method” (Sep. 5, 2006) describe a particle beam irradiationapparatus have a scanning controller that stops output of an ion beam,changes irradiation position via control of scanning electromagnets, andreinitiates treatment based on treatment planning information.

T. Norimine, et. al. “Particle Therapy System Apparatus”, U.S. Pat. Nos.7,060,997 (Jun. 13, 2006); T. Norimine, et. al. “Particle Therapy SystemApparatus”, 6,936,832 (Aug. 30, 2005); and T. Norimine, et. al.“Particle Therapy System Apparatus”, 6,774,383 (Aug. 10, 2004) eachdescribe a particle therapy system having a first steering magnet and asecond steering magnet disposed in a charged particle beam path after asynchrotron that are controlled by first and second beam positionmonitors.

K. Moriyama, et. al. “Particle Beam Therapy System”, U.S. Pat. No.7,012,267 (Mar. 14, 2006) describe a manual input to a ready signalindicating preparations are completed for transport of the ion beam to apatient.

H. Harada, et. al. “Irradiation Apparatus and Irradiation Method”, U.S.Pat. No. 6,984,835 (Jan. 10, 2006) describe an irradiation method havinga large irradiation filed capable of uniform dose distribution, withoutstrengthening performance of an irradiation field device, using aposition controller having overlapping area formed by a plurality ofirradiations using a multileaf collimator. The system provides flat anduniform dose distribution over an entire surface of a target.

H. Akiyama, et. al. “Charged Particle Beam Irradiation Equipment HavingScanning Electromagnet Power Supplies”, U.S. Pat. No. 6,903,351 (Jun. 7,2005); H. Akiyama, et. al. “Charged Particle Beam Irradiation EquipmentHaving Scanning Electromagnet Power Supplies”, U.S. Pat. No. 6,900,436(May 31, 2005); and H. Akiyama, et. al. “Charged Particle BeamIrradiation Equipment Having Scanning Electromagnet Power Supplies”,U.S. Pat. No. 6,881,970 (Apr. 19, 2005) all describe a power supply forapplying a voltage to a scanning electromagnet for deflecting a chargedparticle beam and a second power supply without a pulsating component tocontrol the scanning electromagnet more precisely allowing for uniformirradiation of the irradiation object.

K. Amemiya, et. al. “Accelerator System and Medical AcceleratorFacility”, U.S. Pat. No. 6,800,866 (Oct. 5, 2004) describe anaccelerator system having a wide ion beam control current range capableof operating with low power consumption and having a long maintenanceinterval.

A. Dolinskii, et. al. “Gantry with an Ion-Optical System”, U.S. Pat. No.6,476,403 (Nov. 5, 2002) describe a gantry for an ion-optical systemcomprising an ion source and three bending magnets for deflecting an ionbeam about an axis of rotation. A plurality of quadrupoles are alsoprovided along the beam path to create a fully achromatic beam transportand an ion beam with difference emittances in the horizontal andvertical planes. Further, two scanning magnets are provided between thesecond and third bending magnets to direct the beam.

H. Akiyama, et. al. “Charged Particle Beam Irradiation Apparatus”, U.S.Pat. No. 6,218,675 (Apr. 17, 2001) describe a charged particle beamirradiation apparatus for irradiating a target with a charged particlebeam that include a plurality of scanning electromagnets and aquadrupole electromagnet between two of the plurality of scanningelectromagnets.

K. Matsuda, et. al. “Charged Particle Beam Irradiation System and MethodThereof”, U.S. Pat. No. 6,087,672 (Jul. 11, 2000) describe a chargedparticle beam irradiation system having a ridge filter with shieldingelements to shield a part of the charged particle beam in an areacorresponding to a thin region in said target.

P. Young, et. al. “Raster Scan Control System for a Charged-ParticleBeam”, U.S. Pat. No. 5,017,789 (May 21, 1991) describe a raster scancontrol system for use with a charged-particle beam delivery system thatincludes a nozzle through which a charged particle beam passes. Thenozzle includes a programmable raster generator and both fast and slowsweep scan electromagnets that cooperate to generate a sweeping magneticfield that steers the beam along a desired raster scan pattern at atarget.

Beam Shape Control

M. Yanagisawa, et. al. “Particle Beam Irradiation System and Method ofAdjusting Irradiation Field Forming Apparatus”, U.S. Pat. No. 7,154,107(Dec. 26, 2006) and M. Yanagisawa, et. al. “Particle Beam IrradiationSystem and Method of Adjusting Irradiation Field Forming Apparatus”,U.S. Pat. No. 7,049,613 (May 23, 2006) describe a particle therapysystem having a scattering compensator and a range modulation wheel.Movement of the scattering compensator and the range modulation wheeladjusts a size of the ion beam and scattering intensity resulting inpenumbra control and a more uniform dose distribution to a diseased bodypart.

T. Haberer, et. al. “Device and Method for Adapting the Size of an IonBeam Spot in the Domain of Tumor Irradiation”, U.S. Pat. No. 6,859,741(Feb. 22, 2005) describe a method and apparatus for adapting the size ofan ion beam in tumor irradiation. Quadrupole magnets determining thesize of the ion beam spot are arranged directly in front of rasterscanning magnets determining the size of the ion beam spot. Theapparatus contains a control loop for obtaining current correctionvalues to further control the ion beam spot size.

K. Matsuda, et. al. “Charged Particle Irradiation Apparatus and anOperating Method Thereof”, U.S. Pat. No. 5,986,274 (Nov. 16, 1999)describe a charged particle irradiation apparatus capable of decreasinga lateral dose falloff at boundaries of an irradiation field of acharged particle beam using controlling magnet fields of quadrupoleelectromagnets and deflection electromagnets to control the center ofthe charged particle beam passing through the center of a scattererirrespective of direction and intensity of a magnetic field generated byscanning electromagnets.

K. Hiramoto, et. al. “Charged Particle Beam Apparatus and Method forOperating the Same”, U.S. Pat. No. 5,969,367 (Oct. 19, 1999) describe acharged particle beam apparatus where a the charged particle beam isenlarged by a scatterer resulting in a Gaussian distribution that allowsoverlapping of irradiation doses applied to varying spot positions.

M. Moyers, et. al. “Charged Particle Beam Scattering System”, U.S. Pat.No. 5,440,133 (Aug. 8, 1995) describe a radiation treatment apparatusfor producing a particle beam and a scattering foil for changing thediameter of the charged particle beam.

C. Nunan “Multileaf Collimator for Radiotherapy Machines”, U.S. Pat. No.4,868,844 (Sep. 19, 1989) describes a radiation therapy machine having amultileaf collimator formed of a plurality of heavy metal leaf barsmovable to form a rectangular irradiation field.

R. Maughan, et. al. “Variable Radiation Collimator”, U.S. Pat. No.4,754,147 (Jun. 28, 1988) describe a variable collimator for shaping across-section of a radiation beam that relies on rods, which arepositioned around a beam axis. The rods are shaped by a shaping membercut to a shape of an area of a patient go be irradiated.

Beam Energy/Intensity

M. Yanagisawa, et. al. “Charged Particle Therapy System, RangeModulation Wheel Device, and Method of Installing Range Modulation WheelDevice”, U.S. Pat. No. 7,355,189 (Apr. 8, 2008) and Yanagisawa, et. al.“Charged Particle Therapy System, Range Modulation Wheel Device, andMethod of Installing Range Modulation Wheel Device”, U.S. Pat. No.7,053,389 (May 30, 2008) both describe a particle therapy system havinga range modulation wheel. The ion beam passes through the rangemodulation wheel resulting in a plurality of energy levels correspondingto a plurality of stepped thicknesses of the range modulation wheel.

M. Yanagisawa, et. al. “Particle Beam Irradiation System and Method ofAdjusting Irradiation Apparatus”, U.S. Pat. No. 7,297,967 (Nov. 20,2007); M. Yanagisawa, et. al. “Particle Beam Irradiation System andMethod of Adjusting Irradiation Apparatus”, U.S. Pat. No. 7,071,479(Jul. 4, 2006); M. Yanagisawa, et. al. “Particle Beam Irradiation Systemand Method of Adjusting Irradiation Apparatus”, U.S. Pat. No. 7,026,636(Apr. 11, 2006); and M. Yanagisawa, et. al. “Particle Beam IrradiationSystem and Method of Adjusting Irradiation Apparatus”, U.S. Pat. No.6,777,700 (Aug. 17, 2004) all describe a scattering device, a rangeadjustment device, and a peak spreading device. The scattering deviceand range adjustment device are combined together and are moved along abeam axis. The spreading device is independently moved along the axis toadjust the degree of ion beam scattering. Combined, the devise increasesthe degree of uniformity of radiation dose distribution to a diseasedtissue.

A. Sliski, et. al. “Programmable Particle Scatterer for RadiationTherapy Beam Formation”, U.S. Pat. No. 7,208,748 (Apr. 24, 2007)describe a programmable pathlength of a fluid disposed into a particlebeam to modulate scattering angle and beam range in a predeterminedmanner. The charged particle beam scatterer/range modulator comprises afluid reservoir having opposing walls in a particle beam path and adrive to adjust the distance between the walls of the fluid reservoirunder control of a programmable controller to create a predeterminedspread out Bragg peak at a predetermined depth in a tissue. The beamscattering and modulation is continuously and dynamically adjustedduring treatment of a tumor to deposit a dose in a targetedpredetermined three dimensional volume.

M. Tadokoro, et. al. “Particle Therapy System”, U.S. Pat. No. 7,247,869(Jul. 24, 2007) and U.S. Pat. No. 7,154,108 (Dec. 26, 2006) eachdescribe a particle therapy system capable of measuring energy of acharged particle beam during irradiation during use. The system includesa beam passage between a pair of collimators, an energy detectormounted, and a signal processing unit.

G. Kraft, et. al. “Ion Beam Scanner System and Operating Method”, U.S.Pat. No. 6,891,177 (May 10, 2005) describe an ion beam scanning systemhaving a mechanical alignment system for the target volume to be scannedand allowing for depth modulation of the ion beam by means of a linearmotor and transverse displacement of energy absorption means resultingin depth-staggered scanning of volume elements of a target volume.

G. Hartmann, et. al. “Method for Operating an Ion Beam Therapy System byMonitoring the Distribution of the Radiation Dose”, U.S. Pat. No.6,736,831 (May 18, 2004) describe a method for operation of an ion beamtherapy system having a grid scanner and irradiates and scans an areasurrounding an isocentre. Both the depth dose distribution and thetransverse dose distribution of the grid scanner device at variouspositions in the region of the isocentre are measured and evaluated.

Y. Jongen “Method for Treating a Target Volume with a Particle Beam andDevice Implementing Same”, U.S. Pat. No. 6,717,162 (Apr. 6, 2004)describes a method of producing from a particle beam a narrow spotdirected towards a target volume, characterized in that the spotsweeping speed and particle beam intensity are simultaneously varied.

G. Kraft, et. al. “Device for Irradiating a Tumor Tissue”, U.S. Pat. No.6,710,362 (Mar. 23, 2004) describe a method and apparatus of irradiatinga tumor tissue, where the apparatus has an electromagnetically drivenion-braking device in the proton beam path for depth-wise adaptation ofthe proton beam that adjusts both the ion beam direction and ion beamrange.

K. Matsuda, et. al. “Charged Particle Beam Irradiation Apparatus”, U.S.Pat. No. 6,617,598 (Sep. 9, 2003) describe a charged particle beamirradiation apparatus that increased the width in a depth direction of aBragg peak by passing the Bragg peak through an enlarging devicecontaining three ion beam components having different energies producedaccording to the difference between passed positions of each of thefilter elements.

H. Stelzer, et. al. “Ionization Chamber for Ion Beams and Method forMonitoring the Intensity of an Ion Beam”, U.S. Pat. No. 6,437,513 (Aug.20, 2002) describe an ionization chamber for ion beams and a method ofmonitoring the intensity of an ion therapy beam. The ionization chamberincludes a chamber housing, a beam inlet window, a beam outlet window, abeam outlet window, and a chamber volume filled with counting gas.

H. Akiyama, et. al. “Charged-Particle Beam Irradiation Method andSystem”, U.S. Pat. No. 6,433,349 (Aug. 13, 2002) and H. Akiyama, et. al.“Charged-Particle Beam Irradiation Method and System”, U.S. Pat. No.6,265,837 (Jul. 24, 2001) both describe a charged particle beamirradiation system that includes a changer for changing energy of theparticle and an intensity controller for controlling an intensity of thecharged-particle beam.

Y. Pu “Charged Particle Beam Irradiation Apparatus and Method ofIrradiation with Charged Particle Beam”, U.S. Pat. No. 6,034,377 (Mar.7, 2000) describes a charged particle beam irradiation apparatus havingan energy degrader comprising: (1) a cylindrical member having a length;and (2) a distribution of wall thickness in a circumferential directionaround an axis of rotation, where thickness of the wall determinesenergy degradation of the irradiation beam.

Dosage

K. Matsuda, et. al. “Particle Beam Irradiation System”, U.S. Pat. No.7,372,053 (Nov. 27, 2007) describe a particle beam irradiation systemensuring a more uniform dose distribution at an irradiation objectthrough use of a stop signal, which stops the output of the ion beamfrom the irradiation device.

H. Sakamoto, et. al. “Radiation Treatment Plan Making System andMethod”, U.S. Pat. No. 7,054,801 (May 30, 2006) describe a radiationexposure system that divides an exposure region into a plurality ofexposure regions and uses a radiation simulation to plan radiationtreatment conditions to obtain flat radiation exposure to the desiredregion.

G. Hartmann, et. al. “Method For Verifying the Calculated Radiation Doseof an Ion Beam Therapy System”, U.S. Pat. No. 6,799,068 (Sep. 28, 2004)describe a method for the verification of the calculated dose of an ionbeam therapy system that comprises a phantom and a discrepancy betweenthe calculated radiation dose and the phantom.

H. Brand, et. al. “Method for Monitoring the Irradiation Control of anIon Beam Therapy System”, U.S. Pat. No. 6,614,038 (Sep. 2, 2003)describe a method of checking a calculated irradiation control unit ofan ion beam therapy system, where scan data sets, control computerparameters, measuring sensor parameters, and desired current values ofscanner magnets are permanently stored.

T. Kan, et. al. “Water Phantom Type Dose Distribution DeterminingApparatus”, U.S. Pat. No. 6,207,952 (Mar. 27, 2001) describe a waterphantom type dose distribution apparatus that includes a closed watertank, filled with water to the brim, having an inserted sensor that isused to determine an actual dose distribution of radiation prior toradiation therapy.

Starting/Stopping Irradiation

K. Hiramoto, et. al. “Charged Particle Beam Apparatus and Method forOperating the Same”, U.S. Pat. No. 6,316,776 (Nov. 13, 2001) describe acharged particle beam apparatus where a charged particle beam ispositioned, started, stopped, and repositioned repetitively. Residualparticles are used in the accelerator without supplying new particles ifsufficient charge is available.

K. Matsuda, et. al. “Method and Apparatus for Controlling CircularAccelerator”, U.S. Pat. No. 6,462,490 (Oct. 8, 2002) describe a controlmethod and apparatus for a circular accelerator for adjusting timing ofemitted charged particles. The clock pulse is suspended after deliveryof a charged particle stream and is resumed on the basis of state of anobject to be irradiated.

Movable Patient

N. Rigney, et. al. “Patient Alignment System with External Measurementand Object Coordination for Radiation Therapy System”, U.S. Pat. No.7,199,382 (Apr. 3, 2007) describe a patient alignment system for aradiation therapy system that includes multiple external measurementdevices that obtain position measurements of movable components of theradiation therapy system. The alignment system uses the externalmeasurements to provide corrective positioning feedback to moreprecisely register the patient to the radiation beam.

Y. Muramatsu, et. al. “Medical Particle Irradiation Apparatus”, U.S.Pat. No. 7,030,396 (Apr. 18, 2006); Y. Muramatsu, et. al. “MedicalParticle Irradiation Apparatus”, U.S. Pat. No. 6,903,356 (Jun. 7, 2005);and Y. Muramatsu, et. al. “Medical Particle Irradiation Apparatus”, U.S.Pat. No. 6,803,591 (Oct. 12, 2004) all describe a medical particleirradiation apparatus having a rotating gantry, an annular frame locatedwithin the gantry such that is can rotate relative to the rotatinggantry, an anti-correlation mechanism to keep the frame from rotatingwith the gantry, and a flexible moving floor engaged with the frame issuch a manner to move freely with a substantially level bottom while thegantry rotates.

H. Nonaka, et. al. “Rotating Radiation Chamber for Radiation Therapy”,U.S. Pat. No. 5,993,373 (Nov. 30, 1999) describe a horizontal movablefloor composed of a series of multiple plates that are connected in afree and flexible manner, where the movable floor is moved in synchronywith rotation of a radiation beam irradiation section.

Respiration

K. Matsuda “Radioactive Beam Irradiation Method and Apparatus TakingMovement of the Irradiation Area Into Consideration”, U.S. Pat. No.5,538,494 (Jul. 23, 1996) describes a method and apparatus that enablesirradiation even in the case of a diseased part changing position due tophysical activity, such as breathing and heart beat. Initially, aposition change of a diseased body part and physical activity of thepatient are measured concurrently and a relationship therebetween isdefined as a function. Radiation therapy is performed in accordance tothe function.

Patient Positioning

Y. Nagamine, et. al. “Patient Positioning Device and Patient PositioningMethod”, U.S. Pat. Nos. 7,212,609 and 7,212,608 (May 1, 2007) describe apatient positioning system that compares a comparison area of areference X-ray image and a current X-ray image of a current patientlocation using pattern matching.

D. Miller, et. al. “Modular Patient Support System”, U.S. Pat. No.7,173,265 (Feb. 6, 2007) describe a radiation treatment system having apatient support system that includes a modularly expandable patient podand at least one immobilization device, such as a moldable foam cradle.

K. Kato, et. al. “Multi-Leaf Collimator and Medical System IncludingAccelerator”, U.S. Pat. No. 6,931,100 (Aug. 16, 2005); K. Kato, et. al.“Multi-Leaf Collimator and Medical System Including Accelerator”, U.S.Pat. No. 6,823,045 (Nov. 23, 2004); K. Kato, et. al. “Multi-LeafCollimator and Medical System Including Accelerator”, U.S. Pat. No.6,819,743 (Nov. 16, 2004); and K. Kato, et. al. “Multi-Leaf Collimatorand Medical System Including Accelerator”, U.S. Pat. No. 6,792,078 (Sep.14, 2004) all describe a system of leaf plates used to shortenpositioning time of a patient for irradiation therapy. Motor drivingforce is transmitted to a plurality of leaf plates at the same timethrough a pinion gear. The system also uses upper and lower aircylinders and upper and lower guides to position a patient.

Imaging

P. Adamee, et. al. “Charged Particle Beam Apparatus and Method forOperating the Same”, U.S. Pat. No. 7,274,018 (Sep. 25, 2007) and P.Adamee, et. al. “Charged Particle Beam Apparatus and Method forOperating the Same”, U.S. Pat. No. 7,045,781 (May 16, 2006) describe acharged particle beam apparatus configured for serial and/or parallelimaging of an object.

K. Hiramoto, et. al. “Ion Beam Therapy System and its Couch PositioningSystem”, U.S. Pat. No. 7,193,227 (Mar. 20, 2007) describe a ion beamtherapy system having an X-ray imaging system moving in conjunction witha rotating gantry.

C. Maurer, et. al. “Apparatus and Method for Registration of Images toPhysical Space Using a Weighted Combination of Points and Surfaces”,U.S. Pat. No. 6,560,354 (May 6, 2003) described a process of X-raycomputed tomography registered to physical measurements taken on thepatient's body, where different body parts are given different weights.Weights are used in an iterative registration process to determine arigid body transformation process, where the transformation function isused to assist surgical or stereotactic procedures.

M. Blair, et. al. “Proton Beam Digital Imaging System”, U.S. Pat. No.5,825,845 (Oct. 20, 1998) describe a proton beam digital imaging systemhaving an X-ray source that is movable into the treatment beam line thatcan produce an X-ray beam through a region of the body. By comparison ofthe relative positions of the center of the beam in the patientorientation image and the isocentre in the master prescription imagewith respect to selected monuments, the amount and direction of movementof the patient to make the best beam center correspond to the targetisocentre is determined.

S. Nishihara, et. al. “Therapeutic Apparatus”, U.S. Pat. No. 5,039,867(Aug. 13, 1991) describe a method and apparatus for positioning atherapeutic beam in which a first distance is determined on the basis ofa first image, a second distance is determined on the basis of a secondimage, and the patient is moved to a therapy beam irradiation positionon the basis of the first and second distances.

Problem

There exists in the art of particle beam therapy of cancerous tumors aneed for positioning and verification of proper positioning of a patientimmediately prior to and/or concurrently with particle beam therapyirradiation to ensure targeted and controlled delivery of energy to thecancerous tumor with minimization of damage to surrounding healthytissue.

SUMMARY OF THE INVENTION

The invention comprises a charged particle cancer therapy X-ray methodand apparatus.

DESCRIPTION OF THE FIGURES

FIG. 1 illustrates sub-system connections of a particle beam therapysystem;

FIG. 2 illustrates a synchrotron;

FIG. 3 illustrates an X-ray source proximate a particle beam path;

FIG. 4 illustrates an expanded X-ray beam path; and

FIG. 5 illustrates geometry of an electron and X-ray beam path.

DETAILED DESCRIPTION OF THE INVENTION

The invention comprises a charged particle cancer therapy X-ray methodand apparatus.

Accurate and precise delivery of protons to a tumor in body tissue iscritical in charged particle beam therapy. Complicating accurate andprecise deliver is natural movement of the body. Movement of the bodyoccurs on multiple levels, including: (1) general movement; (2)standing, sitting, or lying position variation; and (3) relativemovement of internal body parts, such as organs. All of these movementschange with time. Hence, a method of determining position of elements ofthe body at or in close proximity in time to the charged particletherapy is needed, such as after the body is positioned relative to acharged particle beam. Herein, an X-ray positioning and/or verificationmethod and apparatus used in conjunction with charged particle therapyis described.

The system uses an X-ray beam that lies in substantially the same pathas a charged particle beam path of a particle beam cancer therapysystem. The system creates an electron beam that strikes an X-raygeneration source where the X-ray generation source is located proximateto the charged particle beam path. By generating the X-rays near thecharged particle beam path, an X-ray path running collinear, in parallelwith, and/or substantially in contact with the charged particle beampath is created. The system then collects X-ray images of localized bodytissue region about a cancerous tumor. Since, the X-ray path isessentially the charged particle beam path, the generated image isusable for fine tuning body alignment relative to the charged particlebeam path, is used to control the charged particle beam path toaccurately and precisely target the tumor, and/or is used in systemverification and validation.

Charged Particle Beam Therapy

Throughout this document, a charged particle beam therapy system, suchas a proton beam, hydrogen ion beam, or carbon ion beam, is described.Herein, the charged particle beam therapy system is described using aproton beam. However, the aspects taught and described in terms of aproton beam are not intended to be limiting to that of a proton beam andare illustrative of a charged particle beam system. Any charged particlebeam system is equally applicable to the techniques described herein.

Referring now to FIG. 1, a charged particle beam system 100 isillustrated. A charged particle beam, preferably comprises a number ofsubsystems including any of: a main controller 110; an injection system120; a synchrotron 130 that typically includes: (1) an acceleratorsystem 140 and (2) an extraction system 150; a targeting/delivery system160; a patient interface module 170; a display system 180, and/or animaging system 190.

An exemplary method of use of the charged particle beam system 100 isprovided. The main controller 110 controls one or more of the subsystemsto accurately and precisely deliver protons to a patient. For example,the main controller 110 obtains an image, such as a portion of a bodyand/or of a tumor, from the imaging system 190. The main controller 110also obtains position and/or timing information from the patientinterface module 170. The main controller 110 then optionally controlsthe injection system 120 to inject a proton into a synchrotron 130. Thesynchrotron typically contains at least an accelerator system 140 andextraction system 150. The main controller preferably controls theproton beam within the accelerator system, such as by controlling speed,trajectory, and timing of the proton beam. The main controller thencontrols extraction of a proton beam from the accelerator through theextraction system 150. For example, the controller controls timing,energy, and intensity of the extracted beam. The controller 110 alsopreferably controls targeting of the proton beam through thetargeting/delivery system 160 to the patient interface module 170. Oneor more components of the patient interface module 170 are preferablycontrolled by the main controller 110. Further, display elements of thedisplay system 180 are preferably controlled via the main controller110. Displays are typically provided to one or more operators and/or toone or more patients. In one embodiment, the main controller 110 timesthe delivery of the proton beam from all systems, such that protons aredelivered in an optimal therapeutic manner to the patient.

Herein, the main controller 110 refers to a single system controllingthe charged particle beam system 100, to a single controller controllinga plurality of subsystems controlling the charged particle beam system100, or to a plurality of individual controllers controlling one or moresub-systems of the charged particle beam system 100.

Synchrotron

Herein, the term synchrotron is used to refer to a system maintainingthe charged particle beam in a circulating path; however, cyclotrons arealternatively used, albeit with their inherent limitations of energy,intensity, and extraction control. Further, the charged particle beam isreferred to herein as circulating along a circulating path about acentral point of the synchrotron. The circulating path is alternativelyreferred to as an orbiting path; however, the orbiting path does notrefer a perfect circle or ellipse, rather it refers to cycling of theprotons around a central region.

Referring now to FIG. 2, an illustrative exemplary embodiment of oneversion of the charged particle beam system 100 is provided. In theillustrated embodiment, a charged particle beam source 210 generatesprotons. The protons are delivered into a vacuum tube that runs into,through, and out of the synchrotron. The generated protons are deliveredalong an initial path 220. Focusing magnets 230, such as quadrupolemagnets or injection quadrupole magnets, are used to focus the protonbeam path. A quadrupole magnet is a focusing magnet. An injector bendingmagnet 232 bends the proton beam toward the plane of the synchrotron130. The focused protons having an initial energy are introduced into aninjector magnet 240, which is preferably an injection Lamberson magnet.Typically, the initial beam path 262 is along an axis off of, such asabove, a circulating plane of the synchrotron 130. The injector bendingmagnet 232 and injector magnet 240 combine to move the protons into thesynchrotron 130. Circulating magnets or main bending magnets 250 areused to turn the protons along a circulating beam path 260. Thecirculating magnets 250 bend the original beam path 220 into acirculating beam path 260. In this example, the circulating magnets 250are represented as four sets of four magnets to maintain the circulatingbeam path 260 into a stable circulating beam path. A plurality of mainbending magnets make up a turning section of the synchrotron. In theillustrated exemplary embodiment, four main bending magnets make up aturning section turning the proton beam about ninety degrees.Optionally, any number of magnets or sets of magnets are optionally usedto move the protons around a single orbit in the circulation process.The protons pass through an accelerator 270. The accelerator acceleratesthe protons in the beam path 260. As the protons are accelerated, thefields applied by the magnets are increased. Particularly, the speed ofthe protons achieved by the accelerator 270 are synchronized withmagnetic fields of the circulating magnets 250 to maintain stablecirculation of the protons about a central point or region 280 of thesynchrotron. At separate points in time the accelerator 270/circulatingmagnet 250 combination is used to accelerate and/or decelerate thecirculating protons. An extraction system 290 is used in combinationwith a deflector 300 to remove protons from their circulating path 260within the synchrotron 190. One example of a deflector component is aLamberson magnet. Typically the deflector moves the protons from thecirculating plane to an axis off of the circulating plane, such as abovethe circulating plane. Extracted protons are preferably directed and/orfocused using an extraction bending magnet 237 and extraction focusingmagnets 235, such as quadrupole magnets along a transport path into thescanning/targeting/delivery system 160. Two components of a targetingsystem 160 typically include a first axis control 162, such as avertical control, and a second axis control 164, such as a horizontalcontrol. Protons are delivered with control to the patient interfacemodule 170 and to a tumor of a patient. Preferably no quadrupoles areused in or around the circulating path of the synchrotron.

Imaging System

Herein, an X-ray system is used to illustrate an imaging system.

Timing

An X-ray is preferably collected either (1) just before or (2)concurrently with treating a subject with proton therapy for a couple ofreasons.

First, movement of the body, described supra, changes the local positionof the tumor in the body. If the subject has an X-ray taken and is thenbodily moved to a proton treatment room, accurate alignment of theproton beam to the tumor is problematic. Alignment of the proton beam tothe tumor using one or more X-rays is best performed at the time ofproton delivery or in the seconds or minutes immediately prior to protondelivery and after the patient is placed into a therapeutic bodyposition, which is typically a fixed position.

Second, the X-ray taken after positioning the patient is used forverification of proton beam alignment to a targeted position, such as atumor and/or internal organ position.

Positioning

An X-ray is preferably taken just before treating the subject to aid inpatient positioning. For positioning purposes, an X-ray of a large bodyarea is not needed. In one embodiment, an X-ray of only a local area iscollected. When collecting an X-ray, the X-ray has an X-ray path. Theproton beam has a proton beam path. Overlaying the X-ray path with theproton beam path is one method of aligning the proton beam to the tumor.However, this method involves putting the X-ray equipment into theproton beam path, taking the X-ray, and then moving the X-ray equipmentout of the beam path. This process takes time. The elapsed time whilethe X-ray equipment moves has a couple of detrimental effects. First,during the time required to move the X-ray equipment, the body moves.The resulting movement decreases precision and accuracy of subsequentproton beam alignment to the tumor. Second, the time require to move theX-ray equipment is time that the proton beam therapy system is not inuse, which decreases the total efficiency of the proton beam therapysystem.

Referring now to FIG. 3, in one embodiment, an X-ray is generated closeto, but not in, the proton beam path. A proton beam therapy system andan X-ray system combination 300 is illustrated in FIG. 3. The protonbeam therapy system has a proton beam 310 in a transport system afterthe deflector 300 of the synchrotron 190. The proton beam is directed bythe targeting/delivery system 160 to a tumor 320 of a patient 330. TheX-ray system includes an electron beam source 340 generating an electronbeam 350. The electron beam is directed to an X-ray generation source360, such as a piece of tungsten. Preferably, the tungsten X-ray sourceis located about 1, 2, 3, 5, 10, or 20 millimeters from the proton beampath 310. When the electron beam 35 hits the tungsten, X-rays aregenerated in all directions. X-rays are optionally blocked with a port410 and are selected for an X-ray beam path 370. The X-ray beam path 370and proton beam path 310 run substantially in parallel to the tumor 320.The distance between the X-ray beam path 370 and proton beam pathdiminishes to near zero and/or the X-ray beam path 370 and proton beampath 310 overlap by the time they reach the tumor 320. Simple geometryshows this to be the case given the long distance, of at least a meter,between the tungsten and the tumor 320. The distance is illustrated as agap 380 in FIG. 3. The X-rays are detected at an X-ray detector 390,which is used to form an image of the tumor 320 and/or position of thepatient 330.

X-Ray Source Lifetime

Preferably, components in the particle beam therapy system requireminimal or no maintenance over the lifetime of the particle beam therapysystem. For example, it is desirable to equip the proton beam therapysystem with an X-ray system having a long lifetime source, such as alifetime of about 20 years.

In one system, described infra, electrons are used to create X-rays. Theelectrons are generated at a cathode where the lifetime of the cathodeis temperature dependent. Analogous to a light bulb, where the filamentis kept in equilibrium, the cathode temperature is held in equilibriumat temperatures at about 200, 500, or 1000 degrees Celsius. Reduction ofthe cathode temperature results in increased lifetime of the cathode.Hence, the cathode used in generating the electrons is preferably heldat as low of a temperature as possible. However, if the temperature ofthe cathode is reduced, then electron emissions also decrease. Toovercome the need for more electrons at lower temperatures, a largecathode is used and the generated electrons are concentrated. Theprocess is analogous to compressing electrons in an electron gun;however, here the compression techniques are adapted to apply toenhancing an X-ray tube lifetime.

Referring still to FIG. 3, an example of an X-ray generation devicehaving an enhanced lifetime is provided. Electrons 350 are generated ata cathode 342, focused with a control electrode 344, and acceleratedand/or focused with a series of accelerating electrodes 346 and/ormagnetic lenses 348. The accelerated electrons impact an X-raygeneration source 360 resulting in generated X-rays that are thendirected along an X-ray path 370 to the subject 330. The concentratingof the electrons from a first diameter to a second diameter allows thecathode to operate at a reduced temperature and still yield thenecessary amplified level of electrons at the X-ray generation source360. In one example, the X-ray generation source is the anode coupledwith the cathode and/or the X-ray generation source is substantiallycomposed of tungsten.

A more detailed description of an exemplary X-ray generation device isdescribed. An anode/cathode pair is used to generated electrons. Theelectrons are generated at the cathode having a first diameter, which isdenoted d₁. The control electrodes attract the generated electrons. Forexample, if the cathode is held at about −150 kV and the controlelectrode is held at about −149 kV, then the generated electrons areattracted toward the control electrodes and focused. A series ofaccelerating electrodes are then used to accelerate the electrons into asubstantially parallel path with a smaller diameter, which is denotedd₂. For example, with the cathode held at −150 kV, a first, second,third, and fourth accelerating electrodes are held at about −120, −90,−60, and −30 kV, respectively. If a thinner body part is to be analyzed,then the cathode is held at a smaller level, such as about −90 kV andthe control electrode, first, second, third, and fourth electrode areeach adjusted to lower levels. Generally, the voltage difference fromthe cathode to fourth electrode is less for a smaller negative voltageat the cathode and vise-versa. The accelerated electrons are optionallypassed through a magnetic lens for adjustment of beam size, such as acylindrical magnetic lens. The electrons are also optionally focusedusing quadrupole magnets, which focus in one direction and defocus inanother direction. The accelerated electrons, which are now adjusted inbeam size and focused strike an X-ray generation source, such astungsten, resulting in generated X-rays that pass through a blocker andproceed along an X-ray path to the subject. The X-ray generation sourceis optionally cooled with a cooling element, such as water touching orthermally connected to a backside of the X-ray generation source. Theconcentrating of the electrons from a first diameter to a seconddiameter allows the cathode to operate at a reduced temperature andstill yield the necessary amplified level of electrons at the X-raygeneration source.

More generally, the X-ray generation device produces electrons havinginitial vectors. One or more of the control electrode, acceleratingelectrodes, magnetic lens, and quadrupole magnets combine to alter theinitial electron vectors into parallel vectors with a decreasedcross-sectional area having a substantially parallel path, referred toas the accelerated electrons. The process allows the X-ray generationdevice to operate at a lower temperature. Particularly, instead of usinga cathode that is the size of the electron beam needed, a largerelectrode is used and the resulting electrons are focused and/orconcentrated into the required electron beam needed. As lifetime isroughly an inverse of current density, the concentration of the currentdensity results in a larger lifetime of the X-ray generation device. Aspecific example is provided for clarity. If the cathode has a fifteenmm radius or d₁ is about 30 mm, then the area (π r²) is about 225 mm²times pi. If the concentration of the electrons achieves a radius offive mm or d₂ is about 10 mm, then the area (π r²) is about 25 mm² timespi. The ratio of the two areas is about nine (225π/25π). Thus, there isabout nine times less density of current at the larger cathode comparedto the traditional cathode having an area of the desired electron beam.Hence, the lifetime of the larger cathode approximates nine times thelifetime of the traditional cathode, though the actual current throughthe larger cathode and traditional cathode is about the same.Preferably, the area of the cathode is about 2, 4, 6, 8, 10, 15, 20, or25 times that of the cross-sectional area of the substantially parallelelectron beam 2150.

Electron Beam/X-Ray Geometry

Referring now to FIG. 4, an additional optional geometry configurationof the electron beam path 350 and X-ray beam path 370 shown in FIG. 3 ispresented. Particularly, the electron beam 350 is shown as an expandedbeam path 352, 354. Also, the X-ray beam path 370 is shown as anexpanded beam path 312, 314. Still further, the proton beam path 310 isillustratively shown as scanning from the bottom of the tumor along alower proton beam path 312 to the top of the tumor along an upper protonbeam path 314. The region 400 where the electron beam 350 hits the X-raygeneration source 360 to yield X-rays and an X-ray beam 370 is expandedin FIG. 5.

In another embodiment of the invention, the quadrupole magnets result inan oblong cross-sectional shape of the electron beam. A projection ofthe oblong cross-sectional shape of the electron beam onto the X-raygeneration source results in an X-ray beam that has a small spot incross-sectional view, which is preferably substantially circular incross-sectional shape, that is then passed through the patient. Thesmall spot is used to yield an X-ray having enhanced resolution at thepatient. Referring now to FIG. 5, additional geometry of the electronbeam path 350 and X-ray beam path 370 is illustrated. The electron beamcross section 420 is generally of an oblong or elliptical shape. Forexample, the electron beam cross section 420 has a height 424 of aboutthree millimeters and a width 422 of about ten millimeters. The oblongshape of electrons hits the X-ray generation source 360, which is set atan angle alpha 430 off of the proton beam path 310. An exemplary anglealpha is about fifteen degrees or less preferably five to forty-fivedegrees. Generated X-rays are blocked with a port 410. As a result ofthe geometry of the electron beam path 350, X-ray generation source 360,angle alpha 430, and port 410, the resulting X-ray beam path 370 has across-sectional profile 440 that is generally spot shaped having aheight 444 and a width 442. For example, the height 444 is about threemillimeters and the width of the spot 440 is about three millimeters.

Still referring to FIG. 5, more generally the electron beam path 350,X-ray generation source, angle alpha, and port are optionally configuredto result in the spot 440 being an ellipse or rectangular cross sectionof any dimension. For example, the electron beam path is optionallycontrolled to have a width of about 1 to 10 millimeter and a height ofabout 1 to 20 millimeters to result in a spot 440 having a diameter ofabout 0.5, 1, 2, 4, or 10 millimeters or to have a rectangular shapewith sides of about 1, 2, 5, or 10 millimeters. Further, the systemallows the X-ray beam path to expand in cross sectional dimension as thepath approaches the tumor 320 to allow for imaging of the tumor.

The X-ray generation source, or tungsten material, is preferably cooledwith a cooling element 450. The cooling element is preferably a chambercontaining a coolant, such as water, a water or alcohol based solution,or a solution containing ethylene glycol. The cooling system ispreferably in direct thermal contact with a back side of the tungsten,where the front side of the tungsten is impacted by the electron beam350 in generation of the X-ray beam 370. The coolant is contained in acontainer. The coolant is passive, internally circulated, or circulatedthrough an external heat exchange unit. The cooling system alternativelyuses heat sinks to remove heat from the tungsten with or without theliquid cooling system.

As a whole, the system generates an X-ray beam that lies insubstantially the same path as the proton therapy beam. The X-ray beamis generated by striking a tungsten or equivalent material with anelectron beam. The X-ray generation source is located proximate to theproton beam path. Geometry of the incident electrons, geometry of theX-ray generation material, and geometry of the optional X-ray beamblocker 410 yield an X-ray beam that runs either in substantially inparallel with the proton beam or results in an X-ray beam path thatstarts proximate the proton beam path an expands to cover and transmitthrough a tumor cross-sectional area to strike an X-ray detector arrayor film allowing imaging of the tumor from a direction and alignment ofthe proton therapy beam. The X-ray image is then used to control thecharged particle beam path to accurately and precisely target the tumor,and/or is used in system verification and validation.

Having an X-ray generation source that is proximate the proton beam pathallows for an X-ray of the patient to be collected close in time to useof the proton beam for tumor therapy as the X-ray generation source neednot be mechanically moved prior to proton therapy. For instance, protonirradiation of the tumor occurs within about 1, 5, 10, 20, 30, or 60seconds of when the X-ray is collected. Although the invention has beendescribed herein with reference to certain preferred embodiments, oneskilled in the art will readily appreciate that other applications maybe substituted for those set forth herein without departing from thespirit and scope of the present invention.

1. An X-ray apparatus as part of a particle beam cancer therapy system,said particle beam cancer therapy system irradiating a tumor of apatient with a charged particle beam during use, said apparatuscomprising: an X-ray generation source located within forty millimetersof the charged particle beam, wherein said X-ray source maintains asingle static position: (1) during use of said X-ray source and (2)during tumor treatment with the charged particle beam, wherein X-raysemitted from said X-ray source run substantially in parallel with thecharged particle beam.
 2. The apparatus of claim 1, wherein said X-raygeneration source comprises a tungsten anode.
 3. The apparatus of claim2, further comprising: an electron generating cathode; a controlelectrode; a plurality of accelerating electrodes; a magnetic lens; anda quadrupole magnet, all of said control electrode, said acceleratingelectrodes, said magnetic lens, and said quadrupole magnet locatedbetween said cathode and an X-ray generating anode in said X-raygeneration source, said control electrode, said accelerating electrodes,said magnetic lens, and said quadrupole magnet combining to form asubstantially parallel electron beam with an electron beamcross-sectional area, wherein a cross-sectional area of said cathode isgreater than about eight times that of the electron beam cross-sectionalarea.
 4. The apparatus of claim 3, wherein said substantially parallelelectron beam comprises an oblong cross-sectional shape, whereingeometry of said X-ray generation source yields an X-ray beam comprisinga nearly circular cross sectional shape when struck by the electron beamhaving said oblong cross-sectional shape, the X-ray beam runningsubstantially in parallel with the charged particle beam.
 5. Theapparatus of claim 4, further comprising a cooling element connected toa backside of said tungsten anode.
 6. The apparatus of claim 1, whereinuse of said X-ray generation source occurs within thirty seconds ofsubsequent use of the charged particle beam for tumor therapy.
 7. Theapparatus of claim 1, further comprising: a synchrotron accelerating thecharged particle beam, wherein the tumor is targeted using X-ray imagescollected using X-rays from said X-ray generation source, wherein thetumor is treated using the charged particle beam, and wherein the X-raysrun substantially in parallel with the charged particle beam.
 8. Theapparatus of claim 1, wherein said synchrotron comprises: exactly fourturning sections; and no quadrupoles in the circulating path of thesynchrotron.
 9. The apparatus of claim 1, wherein said synchrotroncomprises: exactly four, ninety degree, turning sections.
 10. An X-raymethod as part of a particle beam cancer therapy system, said particlebeam cancer therapy system irradiating a tumor of a patient with acharged particle beam during use, said method comprising the steps of:generating X-rays with an X-ray generation source located within fortymillimeters of the charged particle beam, wherein said X-ray sourcemaintains a single static position: (1) during use of said X-ray sourceand (2) during tumor treatment with the charged particle beam, whereinthe X-rays emitted from said X-ray source run substantially in parallelwith the charged particle beam.
 11. The method of claim 10, wherein saidX-ray generation source comprises a tungsten anode.
 12. The method ofclaim 11, further comprising the step of: generating electrons with acathode, said cathode having a first cross-sectional distance, whereinthe X-rays are generated by the electrons from said cathode strikingsaid tungsten anode.
 13. The method of claim 12, further comprising thesteps of: focusing the electrons from said first cross-sectionaldistance to a second cross-sectional distance with a focusing controlelectrode; and accelerating the electrons with accelerating electrodes,said focusing control electrode and said accelerating electrodes locatedbetween said cathode and said anode.
 14. The method of claim 12, furthercomprising the step of: forming a substantially parallel electron beamwith a control electrode, accelerating electrodes, a magnetic lens, anda quadrupole magnet, all of said control electrode, said acceleratingelectrodes, said magnetic lens, and said quadrupole magnet locatedbetween said cathode and said anode, wherein the electron beam comprisesa cross-sectional area, wherein a cross-sectional area of said cathodeis greater than about eight times that of the electron beamcross-sectional area.
 15. The method of claim 14, further comprising thestep of: forming a substantially circular cross-section X-ray beam,wherein said substantially parallel electron beam comprises an oblongcross-sectional shape, wherein geometry of said X-ray generation sourceyields the substantially circular cross section X-ray when struck by theelectron beam having said oblong cross-sectional shape, the X-ray beamrunning substantially in parallel with the charged particle beam. 16.The method of claim 14, further comprising the step of: cooling saidtungsten anode with a cooling element connected to a backside of saidtungsten anode.
 17. The method of claim 10, further comprising the stepof: using said X-ray generation source within thirty seconds ofsubsequent use of the charged particle beam for tumor therapy.
 18. Themethod of claim 25, further comprising the steps of: accelerating thecharged particle beam with a synchrotron; targeting the tumor targetedusing X-ray images collected using X-rays from said X-ray generationsource; and treating the tumor using the charged particle beam.
 19. Themethod of claim 18, wherein said synchrotron comprises: exactly fourturning sections; and no quadrupoles in the circulating path of thesynchrotron.
 20. The method of claim 19, wherein said synchrotroncomprises: exactly four, ninety degree, turning sections.